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A Word From Our Moderator—Reply
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In Reply: The comments by Drs Deinum and van der Wilt and by Dr Shrier focus on the important question: Once a moderator is found in exploration, what comes next? Both letters propose interesting and potentially viable strategies.
Drs Deinum and van der Wilt propose N-of-1 trials followed up by pooling of the results. Every clinician making treatment decisions for a patient is, in effect, doing an N-of-1 trial, first formulating a hypothesis of what is wrong and what might make it right, testing it, and if the evidence does not support the original hypothesis, reformulating the hypothesis and starting over again. Unfortunately, we cannot generalize results from any such trial or pool multiple N-of-1 trials unless there is consistency in the design.
The research version is a crossover design, in which each patient in a sample is assigned to the 2 treatment groups to be compared in random or . . . [Full Text of this Article]
Helena C. Kraemer, PhD
hck@stanford.edu
Department of Psychiatry and Behavioral Sciences
Stanford University
Stanford, Calif
Ellen Frank, PhD;
David J. Kupfer, MD
Department of Psychiatry
University of Pittsburgh
Pittsburgh, Pa
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A Word From Our Moderator
Japp Deinum and Gert Jan van der Wilt
JAMA. 2007;297(2):156.
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A Word From Our Moderator
Ian Shrier
JAMA. 2007;297(2):156-157.
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RELATED ARTICLE
Moderators of Treatment Outcomes: Clinical, Research, and Policy Importance
Helena C. Kraemer, Ellen Frank, and David J. Kupfer
JAMA. 2006;296(10):1286-1289.
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